With only a fraction of the estimated 30 million older Americans with age-related hearing loss using hearing devices, “the time is ripe for a technology solution that could be helped along by federal action,” said geriatrician Christine Cassel, M.D., last week in a report on hearing issues before a government advisory council.
Cassel, a member of the President’s Council of Advisors on Science and Technology (PCAST), reported her committee’s findings on how technology could help those with mild to moderate age-related hearing loss. Half of adults ages 70 to 79 and nearly 80 percent of those over 80 have this type of hearing loss, she said.
The council is expected to come out with a final report on hearing technology recommendations in the coming months.
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“There’s an urgent need to improve hearing and a great opportunity right now” to encourage the use of technology for those with hearing loss associated with aging, Cassel said. Only an estimated 15 to 30 percent of those with hearing loss use the available hearing technologies, she noted.
Hearing loss, she said, “is a major health and social problem,” resulting in social isolation, the inability to keep working, depression, a higher risk of falls and even dementia.
Unfortunately, Cassel said, there are several obstacles to treatment:
High cost. The average cost for one hearing aid is $2,400, but $4,000 to $8,000 per aid is not uncommon. And most people need two. Medicare doesn’t cover this cost, and neither do many private insurance plans.
Access is complex. People must find a hearing aid provider, and some providers can have arrangements with the hearing aid companies, which limits the choices they offer. The Food and Drug Administration requires a doctor’s approval, although this requirement can be — and frequently is — waived. Still, many people think they need to first see their doctor, and this further limits access.
Social stigma. Eyeglasses don’t carry the same stigma because — thanks in part to over-the-counter and online sales — they are ubiquitous and even considered fashionable. If hearing aids were as common as eyeglasses, there would be less of a stigma about wearing them.
No routine hearing screening. Primary-care doctors don't usually consider hearing health to be their responsibility, so a hearing test or screening is rarely part of a routine medical workup.
Because of these barriers, people will put off getting hearing aids for six to eight years. And when they finally do, Cassel pointed out, it’s much harder to achieve normal hearing because the brain’s auditory processing signal is no longer as responsive as it once was.
Technology and “a few key federal actions” could change this equation, Cassel said.
The primary goal is to reduce costs. If costs go down, insurance might be more likely to cover hearing health. In every other area of electronics, innovation reduces costs. Not so with hearing aids, she explained, because the market is not open to competition.
However, the communications revolution offers an opportunity for competitive marketing. The aging boomer as a consumer is comfortable with trying things out at home, ordering on the Internet and programming devices on a cellphone. All of these could contribute to a greater use of hearing technology.
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Finally, other less-expensive consumer electronics solutions exist — including over-the-counter personal sound amplification products — and federal regulations should allow them to be sold as devices to help the hard of hearing, Cassel said. They could help people with ordinary age-related hearing loss who don’t need fancy features.
As Eric Lander, president and director of the Broad Institute of MIT and Harvard and cochair of the PCAST, put it in summing up Cassel’s presentation: “The market and the situation are out of whack.”
Hearing-health consumers have known this for a long time. Let’s hope the government listens to its appointed advisers.
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